Heart, lungs, and statins: is it an easy cohabitation? Pitfalls and controversies

Statins are drugs extensively used by physicians, employed for years and essential for primary and secondary prevention of cardiovascular disease. There are several active principles on the commercial market with different dosages. They acknowledge multiple beneficial effects, including serum cholesterol reduction, as well as anti-inflammatory, antifibrogenic and pleiotropic properties. Although statins are an undisputed tool in the battle against cardiovascular disease, considered widely effective and safe, a small percentage of patients may develop some side effects that need to be investigated. The hypothesis of a correlation between the use of some statins and the development of interstitial lung disease has been developing in the literature in recent years. However, the potential direct effect of statins on the lungs is controversial and unclear. In addition, the concomitant use of drugs that alter statin metabolism and the synergistic role in inducing lung damage require specific and thorough considerations. Furthermore, the diagnosis of interstitial lung disease may be difficult in patients with concomitant heart disease because of common and sometimes overlapping signs and symptoms. Therefore, this review aims to clarify the possible effects on the respiratory system of statins, pivotal drugs with known and unquestionable beneficial effects on the cardiovascular system, which are in no way questioned.